The Tech Awards 2005: Health
This category was sponsored by Agilent Technologies, and from the public comments the judges had a very hard time deciding which deserved the $50,000 cash prize. During this week the laureates from each category have been making presentations to different audiences around Silicon Valley. Yesterday both the education group and three of the five health laureates presented at different parts of the Santa Clara University campus.
I attended the health meeting, partly to give each one a CD with an unpublished manuscript by William Muraskin, a medical historian who has written extensively about public private partnerships in health. His book is about the Gates Foundation and GAVI, the Global Alliance for Vaccines & Immunization.
The winner of the health category was the HibVaccine Team in Cuba and Canada. Dr. Vicente Verez-Bencomo led the massive Cuban initiative which began fifteen years ago, just before their economy collapsed with the fall of the Soviet Union and the withdrawal of the support and markets in the Communist bloc. The Cubans were spending $2 million a year on imported vaccine (which was new) and decided to make it from scratch on their own to save money and because Castro was very interested in bio-technology. Dr. René Roy, a chemist from the University of Montreal met Vicente-Bencomo and they decided to collaborate. Most of the investment came from the Cuban government which was confident this project would be a success and might even result in an exportable product.
Roy commented about the extraordinary health system in Cuba "the best in the world" and said that the education level of the average person was very high. "You can have a conversation about molecular biology with your bartender or talk about engineering with your cab driver." He mentioned that Verez-Bencomo earned $16 a month which means things have not changed much since I was in Havana in 1994. A lot of professionals were working in the tourist sector where they had access to dollars or Euros and not the Cuban peso--which is how the doctor is paid.
The synthetic vaccine which they developed is cheaper ($1.50 a dose versus $5 for the competition) and the number of "adverse events" in children taking the vaccine dropped from about 80 per 100,000 to 40 per 100,000. They hope to get the cost down as they scale up production and expand their markets. Venezuela is probably a logical choice consider the resources Chavez is providing to Cuba and the presence of so many Cubans in Venezuela.
The U.S. State Department did not provide the Cuban doctor with a visa to attend the awards, even though he had received one early this year for a professional meeting in California. It really works against this country's best interests to hinder this kind of exchange. I spoke with a Belgian doctor who had just attended a professional conference in Athens, Greece. Traditionally it was held in the U.S. but so many doctors from around the world felt hassled when coming to the U.S. or were unhappy with U.S. actions outside our borders that it was switched to Europe. What does that say about the future of scientific exchanges?
Project Impact, Berkeley, California
This was the best presentation of the day, partly because David Green had so many interesting revelations to make about cost of medical devices and how to serve several tiers of patients: those who can't pay, those who can pay something, and those who can pay more than the cost of the service. His background is in public health and he had worked with the Seva Foundation (to which I donated small amounts in the 1980's) which was said to be the only charity that caught Steve Jobs' attention. They performed eye operations in Nepal, but "after the donations dried up" Green embarked on other projects including inter-ocular lenses for cataract patients in India and a low cost hearing aid (Impact 1) their most recent project. .
He uses what he calls 'forensic cost accounting' to work out the details of the true cost of medical equipment (a lens or hearing aid or needle or suture) and has found that most do not cost very much. For instance, the lenses are being produced for $5 at Aurolab in India whereas U.S. companies charge $100. He showed a pie chart of the Indian customers where about 35% pay more than the cost, and this subsidizes the 47% who pay nothing and the 18% who pay part of the cost. Yet the venture still turns a modest profit. The network of eye hospitals in India are doing more than 600,000 operations a year, and this sustainable model has spread to Egypt and many other countries around the world.
Though I am skeptical about the rhetoric associated with 'selling to the bottom of the pyramid' i.e. the poor who are often excluded from marketing plans, or with Coke's marketing of sugar water or the infamous Nestle's baby formula campaign in Africe, Green's examples and track record show that it does work in some cases. Coming from his lips the phrase "compassionate capitalism" does not seem to be an oxymoron.
Dr. Joshua Silver, University of Oxford, United Kingdom
He had to return home and did not present, but his AdSpecs are certainly worth mentioning. These are adjustable spectacles where the user can pump fluid into the flexible lenses and adjust the glasses himself. It is evident that professional care is welcome but it is rare in so many locales, and a user-configurable device makes the remedies available in many more places and at low cost, currently $10 a unit (made in China, of course).
Partners in Health, Boston, MA
Hamish Fraser has developed a medical records system using open standards and interfaces that are easy for people with minimum training. They found when working in the slums of Lima that good record keeping was critical in both treating stubborn cases of TB , so-called multi-drug resistant, and AIDS. Much of their current work is in Haiti which Fraser considers perhaps the poorest in the world.
He showed pictures of what passed for a road in rural Haiti near the hospital that was built for their project. It is a comment on the state of Haitian infrastructure that it is the best full-service in the country and is many miles from Port au Prince, the capital. He said that good records did not just satisfy the bureaucratic necessities of a complex operation or for reporting back to donor but that it made a critical difference in the cost of treatment and in the health of the patients. One man was photographed at the time he started treatment. I thought he was about 40 Kg (~90 lbs) and in his 60's, but after treatment for six months the photo revealed a smiling and fit young man in his early 30's.
Fraser also made the comment that VSAT access had been crucial for this hospital. At $4000 for equipment and connection for a year, that's a huge amount of money for a school or telecenter, but for a hospital it can be more easily justified. His testimony confirms my theory that ICT investments in health are more useful because they do not eat up as much of a total budget as it might in an organization that runs on less income.
The WTN was founded by its current chairman, James P. Clark. The first set of 20 awards was presented in 2000. The 2001 World Technology Summit was held in London at Imperial College of Science, Technology, and Medicine and the National Museum of Science & Industry. The 2002 World Technology Summit was held in New York City, in part at United Nations headquarters. The 2003, 2004, 2005 and 2006 World Technology Summit & Awards took place in San Francisco, with the Summits at leading hotels and the Awards ceremony at San Francisco City Hall.
In 2002, the WTN added a Corporate (designated by "Corp", below) award to 10 of the categories. These categories are listed separately. In 2001, the WTN added three categories: Education, Entertainment, and Social Entrepreneurship. In 2002, WTN discontinued three categories: Commerce, Transportation and Start-up Companies.
The X Prize Foundation and WTN announced the WTN X Prize in October 2004.
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